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Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan
Author(s) -
Sato Fuminori,
Nakagawa Ken,
Kawauchi Akihiro,
Matsubara Akio,
Okegawa Takatsugu,
Habuchi Tomonori,
Yoshimura Koji,
Hoshi Akio,
Kinoshita Hidefumi,
Miyajima Akira,
Naitoh Yasuyuki,
Inoue Shogo,
Itaya Naoshi,
Narita Shintaro,
Hanai Kazuya,
Okubo Kazutoshi,
Yanishi Masaaki,
Matsuda Tadashi,
Terachi Toshiro,
Mimata Hiromitsu
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13235
Subject(s) - medicine , nephrectomy , pyeloplasty , surgery , umbilicus (mollusc) , prostatectomy , laparoscopy , adrenalectomy , port (circuit theory) , general surgery , urinary system , prostate , kidney , cancer , hydronephrosis , electrical engineering , engineering
Objective To report on a multi‐institutional series of non‐robotic urological laparoendoscopic single‐site surgery in Japan. Methods Consecutive cases of laparoendoscopic single‐site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. Results Four hundred and sixty‐nine cases were included in the analysis. The most common procedure was adrenalectomy ( n = 177) and the second most common procedure was radical nephrectomy ( n = 143). The procedures also included nephroureterectomy ( n = 40), living donor nephrectomy ( n = 40), pyeloplasty ( n = 30), urachal remnant excision ( n = 9), simple nephrectomy ( n = 7), radical prostatectomy ( n = 6) and others ( n = 17). The access sites included umbilicus ( n = 248, 53%) and other sites ( n = 221, 47%). A transperitoneal approach was used in 385 cases (82%), and retroperitoneal approach in 84 cases (18%). The median operation time of all procedures was 198 min. Conversion to reduced port surgery, conventional laparoscopy, or open surgery was noted in 27 cases (5.8%), 12 cases (2.6%), and two cases (0.4%), respectively, with an overall conversion rate of 8.7%. Intraoperative complications occurred in 10 cases (2.1%). Post‐operative complications were noted in 29 cases (6.2%), including five major complications (1.1%). No mortality was recorded in this series. Conclusions Non‐robotic laparoendoscopic single‐site surgery is technically feasible and safe for various urologic diseases in Japan. Furthermore, urological laparoendoscopic single‐site surgery is a promising minimally invasive surgical option that is feasible for experienced urological surgeons in intermediate‐volume centers as well as high‐volume centers.